iCAT flx CBCT in dentistry
The new iCAT flx is an amazing piece of technology that Dr. Bryan and Danielle Bauer added to their practice in 2013. CBCT technology allows for incredible detail and much more efficient and effective treatment by allowing doctors to see in 3 dimensions what your bones and soft tissue really look like. This reduces possible complications and results in a better plan for your treatment. Plus the flx actually reduces the amount of radiation that is used compared to traditional film xrays! It is primarily used for:
- CBCT ensures that vital areas are located and avoided during surgery.
- It ensures that enough quality bone exists to place a dental implant(s) in the desired area.
- Our iCAT accurately evaluates complications of existing implants or previous surgeries.
- Our doctors can very quickly plan and show the patient exactly where the planned location for an implant is located in the bone.
- CBCT is required to accurately plan for advanced surgically accelerated orthodontics.
- The iCAT flx allows us to accurately diagnose the positions of teeth, including roots so a more efficient treatment can be accomplished.
- CBCT allows us to see the entire airway, so we can better position the jaws and teeth to accommodate your airway (we can also plan for surgery to open up the airway).
- Better confidence = more efficient and predictable outcomes for orthodontics!!
- CBCT is used to evaluate the amount of air space available in the throat for breathing.
- We use our iCAT to compare how the use of a sleep appliance impacts that air space.
- iCAT flx in particular reduces the radiation exposure level from around 24µSV to 9µSV (for reference a flight from San Fran to LA exposes you to 11µSV and San Fran to NY is 74µSV of natural background radiation SO although there is a large reduction the numbers are really not very relevant due to the small size to start with)
- CBCT allows us to find problems much earlier.
- CBCT more accurately diagnosis existing problems (such as carotid calcifications, dental implant problems, and root canal problems)
- iCAT diagnoses vertical root fracture better than other CBCT imaging.
- CBCT aides in diagnosis of hard tissue conditions with the TMJ.
- Our iCAT ensures that vital areas are located and avoided during surgery.
- It also allows us to better appreciate possible complications with surgery and aids in planning what to do.
Results Child phantom doses were on average 36% greater than adult phantom doses. QuickScan+ protocols resulted in significantly lower doses than standard protocols.
Conclusions QuickScan+ effective doses are comparable with conventional panoramic examinations. Significant dose reductions are accompanied by significant reductions in image quality. However, this trade-off might be acceptable for certain diagnostic tasks such as interim assessment of treatment results. One potential means of reducing patient risk from CBCT examinations is to limit the area of exposure using variable FOVs that are sized for the location of the anatomy of interest. However, voxel size is linked to FOV in many CBCT units, and smaller voxel sizes associated with smaller FOVs can actually increase the dose because of increases in exposure that are needed to maintain an adequate contrast-to-noise ratio. Another approach is to reduce exposure for diagnostic tasks that theoretically require lower contrast-to-noise ratios or lower signal modulation transfer functions.
Effective doses (μSv) for the adult phantom by exposure protocol and FOV (ANOVA P value and Tukey HSD)
Effective doses (μSv) for the child phantom by exposure protocol and FOV (ANOVA P value and Tukey HSD)
Relevant to this issue, the results of our study demonstrate that effective doses were an average of 36% greater in the child phantom than in the adult phantom. Not only is the effective dose one third higher, but also, due to the increased radiosensitivity of tissues, the risk is an additional 2 to 5 times higher to a pediatric patient. This is important information to consider when determining what type of diagnostic imaging might be best for a patient.We have shown that the QuickScan+ protocol provided a substantial 87% reduction in dose compared with the standard exposure protocols in both child and adult phantoms. Thus, when QuickScan+ protocols can be used, they will provide a clinically meaningful reduction in dose. The largest Quick Scan+ dose recorded in this study (18 μSv) was for the 13 × 16-cm child cephalometric scan. This dose is little more than 2 days of per capita background radiation in the United States. The full FOV QuickScan+ protocols are also less than the combined doses of representative modern digital 2-dimensional panoramic and cephalometric radiographs (14-24 and 4 μSv, respectively).SureSmile scan protocol requires a high-resolution, 0.2-mm voxel scan. We did not conduct high-resolution imaging of the pediatric phantom; however, we found that pediatric phantom doses were on average 36% greater than adult phantom doses. Hence, the estimated high-resolution SureSmile dose for the average orthodontic patient most likely is between 148 and 198 μSv. In May 2012, OraMetrix announced that they will now accept a “14.7”-second scan instead of the high-resolution “26.9”-second scan, dropping the estimated dose for a 16 × 8-cm SureSmile scan to between 97 μSv and 132 μSv for the average patient.
Bryan Bauer, DDS, FAGD 630-665-5550